Tier B

Berberine (Berberis alkaloid)

Also known as: Berberine HCl · Berberine sulfate · Dihydroberberine (DHB)

36 PMID anchor · METABOLISM · ENDO · CARDIO · GUT · Last reviewed 2026-05-29

Mechanism of action

  • AMPK activation
  • Hepatic gluconeogenesis suppression
  • Gut microbiome modulation
  • PCSK9 mRNA suppression (lipid effect)

Molecular + tissue targets

  • Hepatic AMPK axis
  • Glycemic regulation
  • LDL-cholesterol pathway
  • Gut microbiota

Dosage range

500 mg t.i.d. (1500 mg/day total) standard; dihydroberberine 100-200 mg/day better absorbed; take with meals

Safety notes

GI upset (constipation/diarrhea) common; CYP3A4/CYP2D6 inhibition (drug interactions · metformin, statins, immunosuppressants); contraindicated in pregnancy (uterotonic theoretical); not equivalent to metformin (despite popular framing)

Cross-market regulatory status

🇺🇸 FDA

DSHEA dietary supplement; not GRAS; FDA warning letters on diabetes/cholesterol disease claims

🇪🇺 EFSA

Not authorized as food supplement claim; Novel Food considerations

🇧🇷 ANVISA

RDC 243/2018 dietary supplement framework · IN 28/2018 alegação funcional not authorized

Common use cases

  • glycemic regulation (research context)
  • lipid management adjunct
  • metabolic syndrome support
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